North Dakota Medicaid State Plan Amendment Approval

Medicaid State Plan Amendments

Published January 5th, 2026

Detected March 13th, 2026

Summary

The Centers for Medicare & Medicaid Services (CMS) approved North Dakota's State Plan Amendment (SPA) 26-0008 on March 10, 2026. This amendment updates the designee responsible for State Plan submissions. The SPA was effective January 5, 2026.

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What changed

The Centers for Medicare & Medicaid Services (CMS) has approved North Dakota's Medicaid State Plan Amendment (SPA) 26-0008, with an effective date of January 5, 2026. The amendment's primary purpose is to update the designated individual or office responsible for submitting State Plan amendments. This action follows a review by CMS under Title XIX of the Social Security Act and relevant regulations.

This approval signifies a minor administrative update to North Dakota's Medicaid program. Regulated entities within North Dakota, primarily state government agencies involved in Medicaid administration, should note the updated designee for future submissions. No immediate compliance actions are required for external stakeholders, as this change pertains to internal state agency designation processes.

Source document (simplified)

Table of Contents State/Territory Name: North Dakota State Plan Amendment (SPA) #: 26-0008 This file contains the following documents in the order listed: 1) Approval Letter 2) CMS 179 Form/Summary Form (with 179-like data) 3) Approved SPA Page

DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 601 E. 12th St., Room 355 Kansas City, Missouri 64106 Medicaid and CHIP Operations Group March 10, 2026 Krista Fremming Interim Director Medical Services Division ND Department of Health and Human Services 600 East Boulevard Avenue, Dept. 325 Bismark, ND 58505 Re: North Dakota State Plan Amendment (SPA) – 26-0008 Dear Director Fremming: The Centers for Medicare & Medicaid Services (CMS) reviewed your Medicaid State Plan Amendment (SPA) submitted under transmittal number (TN) ND-26-0008. This amendment proposes to amend the State Plan to update the designee for State Plan submissions. We conducted our review of your submittal according to statutory requirements in Title XIX of the Social Security Act and implementing regulations 42 CFR 430.12(b). This letter informs you that North Dakota’s Medicaid SPA TN 26-0008 was approved on March 10, 2026, with an effective date of January 5, 2026. Enclosed are copies of Form CMS-179 and approved SPA pages to be incorporated into the North Dakota State Plan. If you have any questions, please contact Tyson Christensen at (816) 426-6440 or via email at Tyson.Christensen@cms.hhs.gov. Sincerely, Wendy E. Hill Petras Acting Director, Division of Program Operations Enclosures cc: LeeAnn Thiel CENTERS FOR MEDICARE & MEDICAID SERVICES CENTER FOR MEDICAID & CHIP SERVICES

DEPARTMENT OF HEAL TH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVIC ES TRANSMITTAL AND NOTICE OF APPROVAL OF STA TE PLAN MATERIAL FOR: CENTERS FOR MEDICARE & MEDICAID SERVICES TO: CENTER DIRECTOR CENTERS FOR MEDICAID & CHIP SERVICES DEPARTMENT OF HEAL TH AND HUMAN SERVICES 1. TRANSMITTAL NUMBER 2. STATE 2 6 - 0 0 0 8 ND --------3. PROGRAM IDENTIFICATION: TITLE OF THE SOCIAL SECURITY ACT ~ XIX XXI 4. PROPOSED EFFECTIVE DATE January 5, FORM APPROVED 0 MB No. 0938--0193 5. FEDERAL STATUTE/REGULATION CITATION 6. FEDERAL BUDGET IMPACT (Amounts in WHOLE dollars) a FFY 2026 $ 0 42 CFR 430.12(b) b. FFY $ 0 7. PAGE NUMBER OF THE PLAN SECTION OR ATTACHMENT 8. PAGE NUMBER OF THE SUPE RSEDED PLAN SECTION OR ATTACHMENT ( If Applicable) Page 89 ( TN 23-0025) 9. SUBJECT OF AMENDMENT Amends the State Plan to update the designee for State Plan submissions. 10. GOVERNOR'S REVIEW (Ch eck One) 0 GOVERNOR'S OFFICE REPORTED NO COMMENT 0 COMMENTS OF GOVERNOR'S OFFICE ENCLOSED 0 NO REPLY RECEIVED WITHIN DAYS OF SUBMITTAL . SIGNATURE OF STATE AGENCY OFFICIAL @ OTHER, AS SPECIFIED: Krista Fremmi ng, Interim Director Medical Services Divisi on 15. RETURN TO Krista Fremming, Interim Director -------------1 Medical Services Division 12. TYPED NAME Krista Fremming ND Department of Health and Human Services -------------------------1 600 East Boulevard Avenue Dept 325 13. TITLE Bismarck ND 58505-0250 Interim Medical Services Director 14. DATE SUBMITTED January 5, 2026 16. DATE RECEIVED FOR CMS USE ONLY 17. DATE APPROVED Januai 5 2026 Mai·ch , 2026 PLAN APPRO VED· ONE COPY ATTACHED 18. EFFECTIVE DATE OF APPROVED MATERIAL j 19. SIGNATURE OF APPROVING OFFICIAL Januaiy 5, 2026 . TYPED NAME OF APPROVING OFFICIAL Wend E. Hill Petras . REMARKS FORM CMS-(09/24) . TITLE OF APPROVING OFFICIAL Actin Director Division of Pro Instruc tions on Back erations

Revisi on: CMS-PM-91-4 August 1991 (BPD) 0MB No. 0938- State/Territory: __ ......,.N __ o .... rt...,h __ D .... a __ k __ o __ ta ___ _ Citation 7.4 State Governor's Review 42 CFR 430.12(b) The Medicaid agency w ill provide opportunity for the Office of the Governor to review State plan amendments, long-range program planning projections and other periodic reports thereon, excluding periodic statistical, budget and fiscal reports. Any comments made will be transmitted to the Centers for Medicare & Medicaid Services with such document s. G Not applicable. The Governor - Does not wish to review any plan material. Wishes to review only the plan materials specified in the enclosed document. We hereby certify that we are authorized to submit this plan on behalf of North Dakota Department of Health and Human Services, Medical Services Division (Designated Single State Agency) Date: O 1/05/2026 _...;;....;..;..;;;..;;.c.=.;c.=.;;'-------Date: O 1/05/2026 _..;;....;..;..;;;..;;.~.=.;;.--(Signature) (Signature) Interim Director, Medical Services Assistant Director, Medical Services (Title) (Title) TN No. 26-0008 Approval Date 03-10-2026 Effective Date 01-05-2026 Supersedes TN No. 23-0025 CMS I D: 7982E